Tennessee: Combination of Injury and Cocktail of Medications to Treat Nurse’s Continuing Symptoms Equates to Permanent and Total Disability Award

A Special Workers’ Compensation Panel of the Supreme Court of Tennessee recently affirmed a judgment of a trial court that found a worker, a registered nurse, to be permanently and totally disabled in spite of arguments by her former employer that she had the capability to return to gainful employment outside the field of nursing [Mousseau v. Davita, Inc., 2012 Tenn. LEXIS 72 (Feb. 17, 2012)]. Acknowledging that the injured employee had acquired impressive skills during her work as a nurse–she managed three dialysis clinics at the time of her injury–the special panel indicated the evidence supported the finding that the employee also had a substantial limitation upon her cognitive and analytical abilities due to the effects of the many medications required to manage her ongoing pain, neurological symptoms, and depression.  

The employee sustained injuries to her neck and lower back when she slipped in a pool of water and landed on her tail bone. An MRI revealed bone spurring in the cervical spine, including spinal cord compression at the C6-C7 level. A cervical discectomy and fusion at that level was performed and initially the employee’s symptoms improved. After several months, however, she again began to experience leg clumsiness and numbness in her lower body. She also had episodes of urinary incontinence. Subsequent surgery improved her condition somewhat, but she continued to be limited in her activities.

Once, when she attempted to drive her son to school, she was arrested for DUI–her erratic driving caused by the effects of her various medications. Those medications included: Antivert, an antiseizure medication; Soma, a muscle relaxer; Lyrica, for neurologic symptoms; Percocet, a pain medication; Klonopin, an antianxiety medication; and, Cymbalta, an antidepressant. The employee had also been taking Methadone but had discontinued that medication after the DUI incident. She took additional medications for pre-existing thyroid and high blood pressure problems and to treat her incontinence.

The former employer contended that the employee enjoyed a high skill set. Indeed, in spite of her somewhat limited education–she had a GED and an associate’s degree in nursing, the employee had received a certification in nephrology in 1999 and had worked in dialysis-related care both before and after that time. Prior to her move to Tennessee in 2005, the employee had been a facility administrator with responsibilities for as many as thirty-two dialysis clinics in California. The employer argued that while the employee had not sought employment since her fall, she was quite capable of performing a host of gainful activities. A licensed clinical psychologist opined that the skills the employee had obtained as a registered nurse could be transferred to 133 other job positions, but that based upon restrictions placed upon the employee by her treating physicians, all but two of those were excluded and neither was available in her area of Tennessee.

The special panel indicated in relevant part that the evidence did not preponderate against the trial court’s findings. The limitations in her cognitive and analytical abilities brought about by the combination of medications effectively precluded her from working anywhere.

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